Our face is made up of a complex network of bones which form the basic facial structure. So, whenever a facial fracture takes place, it poses a complicated surgical problem in front of the surgeons. When facial fractures occur, mostly multiple fractures occur on the face. It is unlikely that a force which can fracture one part of the face would not affect the other parts of the face. Also, a facial fracture is mostly accompanied by damage to the soft tissues and facial muscles.
How are facial fractures classified?
Facial fractures are classified and their surgical treatment is done on the basis of the location of the facial fracture. So facial fractures can be categorized as follows:-
- Fractures of the forehead: – The forehead is made up of the frontal bone and any trauma directed at the forehead can cause the frontal bone to fracture. Along with frontal bone fracture, the floor of the sinus may also fracture. As the thickness of the frontal bone is least at the mid section, the fracture generally takes place here.
- Fracture of the zygomaticomaxillary arch: – Fracture of the ZMC affects the upper jaw and the cheekbones. Since the cheekbones are connected to the skull and the jaw at multiple points, fracture to the ZMC causes many ripple fractures as well.
- Fracture of the nose: – Nasal fractures occur quite commonly because nose is one of the most prominent facial features. Also, the bones of the nose are thin and fragile. This makes the nose very susceptible to fracture.
- Orbital fractures: – The orbital area can also be fractured which can damage the eyes and the socket. Orbital fractures are of three types.
- Le fort fractures: – Facial fractures which affect the middle portion of the face are called the Lefort fractures. Depending upon the location of the fracture, the Lefort fractures are classified as Lefort I fracture, Lefort II fracture and Lefort III fracture.
- Fractures of the jaw:- Mandibular fractures are the fractures of the jaw which can cause extreme pain to the patient along with major difficulty in opening the mouth. Fractures of the mandible generally cause the teeth to break as well.
If facial fractures are not treated in time they can prove to be fatal in some cases. Except a few cases of facial fractures, surgical intervention becomes necessary in most cases of facial fractures. To avoid any unwanted complication after a facial fracture, a patient should take the treatment as soon as he can. Facial fractures can damage the neuro system as well.
Surgical treatment of facial fractures performed in India using plates for fixation:-
Facial fractures require the best surgical treatment to completely get healed. But one of the top problems in the treatment of facial fractures is bone fixation. Unlike the rest of the body, the facial fractures are difficult to be kept inside a cast. Therefore to reposition the broken bones of the face and to ensure that the bones heal in the best way possible, surgical plates are used. Just like splints are used for fixation of the bones of the body, surgical plates are used as splints but inside the body. In India, generally surgical plates are fixed in to the desired location by attaching screws on the top. The surgical screws are not like the regular hardware that we see commonly in India. They are special screws which vary in size depending upon the bone and the plates they will be used on. In some cases of facial fractures, surgical plates are removed while in some cases the plates are left in the body. The surgical plates which are used for fixing the facial fractures are used to keep the fractured bones in place once they are repositioned. The facial bones are brought together after the fracture then held together by plates and screws. The plates for fixation can be of either titanium of steel. The plates used for fixation are different from the plates used for bone replacement. The plates help in quicker restoration of function. Also because of plates healing is much quicker. If there is a flaw in the surgical technique, the plate may break causing even more damage to the facial bones.
The use of surgical plates for facial fractures dates back many centuries. So, the fact that it is still used today in India proves that is one of the best and time- tested methods for facial fracture repair. One of the top advantages of using surgical plates for repair of facial fracture is that there is almost no chance of any mistake in joining the bones.
Surgical plate fixation may be the best method for joining the facial fractures. However, according to Dr. Debraj Shome in Mumbai, caution needs to be exercised while implanting surgical plates in a patient. He has performed many surgical plates fixation in Mumbai and his expertise on the topic is the best in India. According to Dr. Shome, though surgical plates rarely cause an infection, many times in India malpractices with surgical plates have led to severe consequences. In India, the surgical techniques are improving phenomenally but infection because of plates is still one of the top concerns with surgical plates because there is a lack of high standard sterile institutions in India. In many government run hospitals of India, the state of hygiene is abysmal. Yet, many people of India are forced to take treatments involving surgical plates in such conditions due to lack of standard healthcare throughout India This concern led to Dr. Shome provide quality healthcare in his clinics in Mumbai. One of the top reasons that he established his practice in Mumbai is to provide best treatment to the people who come to Mumbai from various parts of India. Dr. Shome’s effort and vision are consistent and he aims to provide the best in medicine at his clinics in Mumbai. ‘The Esthetic Clinics’ is one such novel medical idea which has been executed by Dr. Shome in Mumbai.
As a consultant to many hospitals in Mumbai, he regularly deals with patients from all corners of the country who need facial fixation with plates. He wants to ensure that residents of cities other than Mumbai also do not face any lack of standard healthcare. Not only his expertise in surgery but also his humanitarian approach towards his patients makes him one of the best doctors in Mumbai.